IPACATE#)'44- 9-3t'�49 Harnett County Department of Public Health 25537
Improvement Permit
A building permit cannot be issued with only an �I�mProvement Permit
PROPERTY LOCATION: �&aQ�.s'0
ISSUED T0: mc3 3 �iosrES �NC- SUBDIVISION LOT # S/0
NEW REPAIR ❑ -H ANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: '5G-:�) ` - �` �' p
Proposed Wastewater System Type: ��I • R£Q` C :;M N \U CW
Projected Daily Flow: L4 i d GPD
Number of bedrooms: L-i Number of Occupants: max
Basement ❑Yes `�<No
Pump Required :Xes ❑ No ❑ May be required based on final location and elevations of facilities
Type of Water Supply: ❑Community Public ❑ Well Distance from well \00 feet Permit valid for: Five years
Permit conditions: ❑ o expiration
Authorized State Agent:: ���� �� \���� iz-G7!!�'5 Date: 1 1 —7 1 1 SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guaranteesZhc ance of other permits. The permit holder is respo Bible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, plat, or the intended use changes. The 0- provement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance
with the attached system layout.
ISSUED TO: Cu PROPERTY LOCATION:
SUBDIVISION ��r�C'F'cxz� LOT # �
Facility Type: S�5.(o Q Cc'a ->�� New ❑ Expansion ❑ Repair
Basement? ❑ Yes 1K No Basement Fixtures? ❑ Yes 'X No
Type of Wastewater System ** euC%rR 'I o ':" ` b 0''G; 1(3N (Initial) Wastewater Flow: �i$ � GPD
(See note below, if applicable ❑)
Pumr70 DL�o (Repair)
Installation Requirements /Conditions Number of trenches t
Septic Tank Size O® O gallons Exact length of each trench a4 O feet Trench Spacing: Feet on Center
Pump Tank Size C) %Q) gallons Trenches shall be installed on contour at a Soil Cover: )Q.° inches
Maximum Trench Depth of: 2 L'--30 inches (Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/ -1/4" 36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM inches below pipe
Aggregate Depth: inches above pipe
Conditions: inches total
* *If applicable: / understand the system type specified is different from the type specified on the app lication. / accept the specifications of this permit.
Owner /Legal Representative Signature: Date:
This Construction Authorization is subject cation if the site plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is eco complia with ions "6 e Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State Agent: Date: _
Const on Authorization Expiration Date:
HTE# )�- -'
Permit # 53-7
Haxnett County Department of Public He(',Itll
Site sketch
PROPERTY LOCATON: PQXs. (-D
ISSUED TO: Cau NIAS-) \A0 nEn. 1NG SUBDIVISION LOT #
Authorized State Agent: iw old J0 Date: 1 1
%-I,/
?pL-j
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIL /SITE EVALUATION
for ON -SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: b&6())0k S-� Design Flow (.1949):IVO
Location of Site: Property Recorded: 11
Water Supply: Public❑ Individual ❑ Well
Evaluation Method: Au er Boring El Pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring ❑ Other
❑ Mixed
P
R
O
F
I
L
E
#
.1940
Landscape
Position/
Slope %
Horizon
Depth
(In.)
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
Profile
Class
& LTAR
.1941
Structure/
Texture
.1941
Consistence
Mineralogy
.1942
Soil
Wetness/
Color
.1943
Soil
Depth (IN.)
.1956
Sapro
Class
.1944
Restr
Horiz
s
S
4�
e�
t.�
IV
}
7yj X 5
n 5 N
Description
Initial
S stem -
Repair System
Other Factors (.1946):
Site Classification (.1948): IV Y
Evaluated By:
Others Present: `
Available Space (.1945)
System Type(s)
Site LTAR
tk 1�
�- Z . 3�